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Yildirim M, Sayin S, Ertas Z, Ayyildiz E, Aksoyoglu I, Avcu F, Ural AU, Ayli M. Apheresis product total CD34 + cell count prediction at peripheral stem cell collection via a formula: A multicenter study. Transpl Immunol 2024; 86:102111. [PMID: 39214288 DOI: 10.1016/j.trim.2024.102111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 08/12/2024] [Accepted: 08/27/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION Effective mobilization of Stem Cells(SCs) to peripheral blood (PB) is crucial for obtaining sufficient CD34+ cell numbers via apheresis. The ratio of pre-apheresis PB CD34+ cells is the best parameter for predicting the product CD34+ cell count. However, quantitating CD34+ PB cells requires flow cytometry, which usually takes two or more hours to obtain the results. We hypothesized that the product CD34+ cell count could be predicted using the counts of white blood cells (WBCs), mononuclear cells (MNCs), and pre-apheresis CD34+ cells. A formula that achieves this would substantially affect the efficiency and effectiveness of apheresis. We, therefore, aimed to estimate the number of CD34+ cells in the product using a formula that incorporates pre-apheresis PB WBC, MNC, and CD34+ cell counts and product WBC and MNC counts. METHODS We examined the results of 373 leukapheresis procedures for SC mobilization. Effective separation of CD34+ PBSCs (count/μL) via apheresis was estimated using the following formula: [Product WBC (count/μL) × MNC (count/μL) × pre-apheresis CD34+ cell (percentage/μL)] ÷ [PB WBC count/μL × PB MNC (count/μL)]. RESULTS A strong correlation was observed between the CD34+ cell count calculated using our formula and the post-apheresis CD34+ cell count measured via flow cytometry (R = 0.939, based on linear regression analysis). In the subgroup analysis, this correlation was observed for all the disease subgroups and healthy donors. CONCLUSION We developed a formula that predicts the product CD34+ cell count and is useful for determining whether a second apheresis procedure will be required.
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Affiliation(s)
- Murat Yildirim
- Gülhane Education and Research Hospital, Department of Hematology and Bone Barrow Transplantation Unit, Ankara, Turkiye
| | - Selim Sayin
- Gülhane Education and Research Hospital, Department of Hematology and Bone Barrow Transplantation Unit, Ankara, Turkiye.
| | - Zerrin Ertas
- Gülhane Education and Research Hospital, Department of Hematology and Bone Barrow Transplantation Unit, Ankara, Turkiye
| | - Erol Ayyildiz
- Ankara Memorial Hospital Department of Hematology and Bone Barrow Transplantation Unit, Ankara, Turkiye
| | - Ilknur Aksoyoglu
- Bayındır Sögütözü Hospital Department of Hematology and Bone Barrow Transplantation Unit, Ankara, Turkiye
| | - Ferit Avcu
- Ankara Memorial Hospital Department of Hematology and Bone Barrow Transplantation Unit, Ankara, Turkiye
| | - Ali Ugur Ural
- Bayındır Sögütözü Hospital Department of Hematology and Bone Barrow Transplantation Unit, Ankara, Turkiye
| | - Meltem Ayli
- Gülhane Education and Research Hospital, Department of Hematology and Bone Barrow Transplantation Unit, Ankara, Turkiye
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Chen L, Wen J, Xu X, Du J, Ruan Y, Feng X, Li J, He Y, Wu X. Safety and efficacy of peripheral blood stem cells collection in healthy children and pediatric patients with thalassemia major weighing 20 kg or less. J Clin Apher 2024; 39:e22102. [PMID: 38186371 DOI: 10.1002/jca.22102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/30/2023] [Accepted: 11/24/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Peripheral blood stem cell (PBSC) collection in children poses challenges due to their small size, low body weight (BW), and unique pediatric physiology, especially among children weighing 20 kg (kg) or less. METHODS PBSC collection data of both healthy children and patients with thalassemia major (TM) weighing 20 kg or less between January 2013 and December 2020 were reviewed. Moreover, PBSCs characteristics along with various aspects of efficiency and safety between healthy donors and patients with TM were compared. RESULTS A total of 262 PBSC procedures were performed on 255 children. Of these, 91 procedures were carried out on 85 allogeneic healthy donors, and 171 auto-backup collections were performed on 170 patients with TM to ensure PBSC availability and prevent transplantation failure. A minimum pre-apheresis hemoglobin (HGB) level of 60 g/L was discovered to be safe and feasible in patients with TM. The median CD34+ cell dose in the PBSC product during the initial apheresis procedure was higher in healthy donors compared to patients with TM (7.29 ± 5.28 × 106 cells/kg vs5.88 ± 4.23 × 106 cells/kg, P = .043). The total CD34+ cells/kg recipient weight exhibited a positive correlation with pre-apheresis monocyte counts, but a negative correlation with donor weight. Apheresis significantly reduced hematocrit and platelet counts in the allogeneic group compared to the autologous group. Patients with TM experienced a higher occurrence of bone pain related to granulocyte colony-stimulating factor treatment. Notably, no serious complications related to PBSCs mobilization, central venous catheter placement, or the apheresis procedure were observed in either group. CONCLUSIONS PBSCs collection was both safe and effective in healthy children and pediatric patients with TM weighing 20 kg or less.
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Affiliation(s)
- Libai Chen
- Department of Pediatrics, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Jianyun Wen
- Department of Pediatrics, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Xiaoxiao Xu
- Department of Pediatrics, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Jing Du
- Department of Pediatrics, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Yongsheng Ruan
- Department of Pediatrics, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Xiaoqin Feng
- Department of Pediatrics, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Juan Li
- Department of Pediatrics, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Yuelin He
- Department of Pediatrics, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Xuedong Wu
- Department of Pediatrics, Southern Medical University Nanfang Hospital, Guangzhou, China
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Thakkar D, Tiwari AK, Pabbi S, Kapoor R, Aggarwal G, Rastogi N, Yadav SP. Peripheral blood stem cell mobilization with pegylated granulocyte colony stimulating factor in children. Cancer Rep (Hoboken) 2021; 4:e1408. [PMID: 34245131 PMCID: PMC8714533 DOI: 10.1002/cnr2.1408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/20/2021] [Accepted: 03/30/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND AND AIM We report here our experience of using pegylated granulocyte colony stimulating factor (peg-GCSF) for peripheral blood stem cell (PBSC) mobilization in children. METHODS AND RESULTS A total of nine children suffering from high-risk/relapsed solid tumors were mobilized with chemotherapy and peg-GCSF (100 microgram/kg single dose). Mean age was 7.7 years (range 2-15 years).The mean time from peg-GCSF administration to PBSC harvest was 9.7 days. Adequate stem cells (median dose 26.9 million/kg) could be harvested in all children by a single apheresis procedure. No major adverse events observed. CONCLUSION It is feasible and safe to mobilize PBSC with peg-GCSF in children with cancer.
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Affiliation(s)
- Dhwanee Thakkar
- Department of Pediatric Hematology Oncology and BMTMedanta The MedicityGurgaonIndia
| | - Aseem K Tiwari
- Department of Transfusion MedicineMedanta The MedicityGurgaonIndia
| | - Swati Pabbi
- Department of Transfusion MedicineMedanta The MedicityGurgaonIndia
| | - Rohit Kapoor
- Department of Pediatric Hematology Oncology and BMTMedanta The MedicityGurgaonIndia
| | - Geet Aggarwal
- Department of Transfusion MedicineMedanta The MedicityGurgaonIndia
| | - Neha Rastogi
- Department of Pediatric Hematology Oncology and BMTMedanta The MedicityGurgaonIndia
| | - Satya Prakash Yadav
- Department of Pediatric Hematology Oncology and BMTMedanta The MedicityGurgaonIndia
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Peripheral Blood Stem Cell Mobilization and Collection in Pediatric Healthy Sibling Donors Weighing 20 Kilograms or Less; Algerian Experience. Transfus Apher Sci 2020; 59:102987. [DOI: 10.1016/j.transci.2020.102987] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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YİĞENOĞLU TN, BAŞCI S, ŞAHİN D, BAKIRTAŞ M, KILINC A, UNCU ULU B, BATGİ H, İSKENDER D, OZCAN N, KIZIL ÇAKIR M, DAL S, HACIBEKİROĞLU T, ALTUNTAŞ F. The effect of smoking on stem cell mobilization in allogeneic donors. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2020. [DOI: 10.32322/jhsm.729505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Healthcare resource utilization and costs associated with acute graft-versus-host disease following allogeneic hematopoietic cell transplantation. Support Care Cancer 2020; 28:5491-5499. [DOI: 10.1007/s00520-020-05382-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 02/26/2020] [Indexed: 11/24/2022]
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Yiğenoğlu TN, Başcı S, Bakırtaş M, Ulu BU, Kılınç A, Şahin D, Darçın T, Yıldız J, Merdin A, Baysal NA, İskender D, Çakar MK, Dal MS, Hacıbekiroğlu T, Altuntaş F. The effect of serum vitamin B12, folate, ferritin levels and transferrin saturation on stem cell mobilization in allogeneic donors. Transfus Apher Sci 2020; 59:102726. [PMID: 32008954 DOI: 10.1016/j.transci.2020.102726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 11/27/2019] [Accepted: 12/23/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Peripheric blood derived stem cells are used in 75 % of allogeneic stem cell transplantations. Iron, vitamin B12 and folate involve in hematopoiesis. Therefore serum levels of iron, vitamin B12 and folat may effect stem cell mobilization. We aimed to analyze the effects of iron status, vitamin B12 and folate levels on peripheric blood stem cell mobilization in healthy donors. METHOD The mobilization results of 218 allogeneic donors were analyzed retrospectively. RESULTS In 64 donors, serum ferritin level was <15 μg / L and transferrin saturation was <20 %. When we compared the donors with iron deficiency to the donors without iron deficiency, the number of collected CD34 + cell was significantly higher in donors without iron deficiency. We did not find any impact of serum vitamin B12 and folate level on CD34+ cells collected. CONCLUSION Our study shows that serum ferritin and transferrin saturation have a greater effect on the amount of CD34+ cells collected from donors than serum vitamin B12 and folate levels. Consequently, when compliance tests of allogeneic donors are performed, the evaluation of vitamin B12 and folate levels is not necessary; whereas iron deficiency must be assessed and -if possible- corrected before apheresis is performed.
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Affiliation(s)
- Tuğçe Nur Yiğenoğlu
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Semih Başcı
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
| | - Mehmet Bakırtaş
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Bahar Uncu Ulu
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ali Kılınç
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Derya Şahin
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Tahir Darçın
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Jale Yıldız
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Alparslan Merdin
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Nuran Ahu Baysal
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Dicle İskender
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Merih Kızıl Çakar
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Mehmet Sinan Dal
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Tuba Hacıbekiroğlu
- Department of Hematology, Sakarya University Hospital, Medical Faculty, Sakarya, Turkey
| | - Fevzi Altuntaş
- Department of Hematology and Bone Marrow Transplantation Center, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Tang F, Mo X, Zhang X, Wang Y, Yan C, Chen Y, Chen H, Han W, Chen Y, Wang F, Wang J, Sun Y, Zhang Y, Liu K, Huang X, Xu L. Influence of the degree of donor bone marrow hyperplasia on patient clinical outcomes after allogeneic hematopoietic stem cell transplantation. SCIENCE CHINA. LIFE SCIENCES 2020; 63:138-147. [PMID: 31432375 DOI: 10.1007/s11427-018-9509-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 05/05/2019] [Indexed: 01/05/2023]
Abstract
This study evaluated the influence of the degree of donor bone marrow (BM) hyperplasia on patient clinical outcomes after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Twelve patients received allo-HSCT from hypoplastic BM donors between January 2010 and December 2017. Forty-eight patients whose donors demonstrated BM hyperplasia were selected using a propensity score matching method (1:4). Primary graft failure including poor graft function and graft rejection did not occur in two groups. In BM hypoplasia and hyperplasia groups, the cumulative incidence (CI) of neutrophil engraftment at day 28 (91.7% vs. 93.8%, P=0.75), platelet engraftment at day 150 (83.3% vs. 93.8%, P=0.48), the median time to myeloid engraftment (14 days vs. 14 days, P=0.85) and platelet engraftment (14 days vs. 14 days, P=0.85) were comparable. The 3-year progression-free survival, overall survival, CI of non-relapse mortality and relapse were 67.8% vs. 71.7% (P=0.98), 69.8% vs. 77.8% (P=0.69), 18.5% vs. 13.6% (P=0.66), and 10.2% vs. 10.4% (P=0.82), respectively. In multivariate analysis, donor BM hypoplasia did not affect patient clinical outcomes after allo-HSCT. If patients have no other suitable donor, a donor with BM hypoplasia can be used for patients receiving allo-HSCT if the donor Complete Blood Count and other examinations are normal.
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Affiliation(s)
- Feifei Tang
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
| | - Xiaodong Mo
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
| | - Xiaohui Zhang
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
| | - Yu Wang
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
| | - Chenhua Yan
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
| | - Yuhong Chen
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
| | - Huan Chen
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
| | - Wei Han
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
| | - Yao Chen
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
| | - Fengrong Wang
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
| | - Jingzhi Wang
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
| | - Yuqian Sun
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
| | - Yuanyuan Zhang
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
| | - Kaiyan Liu
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China
| | - Xiaojun Huang
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China.,Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, 100871, China
| | - Lanping Xu
- Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Beijing, 100044, China.
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Sperm cryopreservation for fertility preservation in male patients with cancer at a single-center in Japan. ACTA ACUST UNITED AC 2019. [DOI: 10.1097/grh.0000000000000034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Plerixafor for patients who fail cytokine-or chemotherapy-based stem cell mobilization: Results of a prospective study by the Polish Lymphoma Research Group (PLRG). ACTA ACUST UNITED AC 2018. [DOI: 10.2478/ahp-2018-0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
AbstractAutologous hematopoietic stem cell transplantation (autoHSCT) requires collection of sufficient number of hematopoietic stem cells. The goal of this study was to evaluate efficacy of plerixafor used in patients with lymphoid malignancies failing conventional stem cell mobilization.This was a prospective, non-interventional study. All consecutive patients (n = 109) treated with plerixafor in 11 centers were reported. The drug was used either in case of previous mobilization failure (n = 67) or interventionally, in case of insufficient CD34+ cell output during current mobilization (n = 42). Successful mobilization was defined as resulting in collection of ≥ 2 × 106 CD34+ cells/kg for single autoHSCT or ≥ 4 × 106 CD34+ cells/kg for double procedure.The overall rate of successful mobilization was 55% (55% for single and 56% for double autoHSCT). The median total number of collected CD34+ cells/kg was 2.4 (range, 0-11.5) for patients intended for a single transplantation while 4.0 (0.6-16.9) for double procedure. The number of circulating CD34+ cells increased after the use of plerixafor regardless of baseline values. The median fold increase was 3.3 (0.3-155). Data from this observational study confirm high efficacy of plerixafor used in routine clinical practice as salvage for patients with lymphoid malignancies failing conventional stem cell mobilization.
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Kuster S, Stampf S, Gerber B, Baettig V, Weisser M, Gerull S, Medinger M, Passweg J, Schanz U, Garzoni C, Berger C, Chalandon Y, Mueller NJ, van Delden C, Neofytos D, Khanna N. Incidence and outcome of invasive fungal diseases after allogeneic hematopoietic stem cell transplantation: A Swiss transplant cohort study. Transpl Infect Dis 2018; 20:e12981. [PMID: 30144374 DOI: 10.1111/tid.12981] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/11/2018] [Accepted: 08/17/2018] [Indexed: 12/23/2022]
Abstract
Contemporary, comprehensive data on epidemiology and outcomes of invasive fungal disease (IFD) including breakthrough IFD among allogeneic hematopoietic stem cell transplantation (HSCT) recipients are scarce. We included 479 allogeneic HSCT recipients with 10 invasive candidiasis (IC) and 31 probable/proven invasive mold disease (IMD) from the Swiss Transplant Cohort Study from 01.2009 to 08.2013. Overall cumulative incidence was 2.3% for IC and 8.5% for probable/proven IMI: 6% for invasive aspergillosis (IA) and 2.5% for non-AspergillusIMI. Among 41 IFD, 46% IFD were breakthrough, with an overall incidence of 4.6%, more frequently caused by other-than-Aspergillus fumigatus molds than primary IFD (47.6% (10/21) vs 13% (3/23), P = 0.04). Twelve-week mortality among patients with IC was 20% and 58.6% for probable/proven IMD (60% IA and 54.6% non-Aspergillus). Our results reveal that breakthrough IFD represent a marked burden of probable/proven IFD postallogeneic HSCT and mortality remains above 50% in patients with probable/proven IMD, underscoring the ongoing challenges to prevent and treat IFD in these patients.
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Affiliation(s)
- Sabine Kuster
- Division of Infectious Diseases and Hospital Epidemiology, University and University Hospital of Basel, Basel, Switzerland
| | - Susanne Stampf
- Clinic for Transplantation Immunology and Nephrology, University Hospital of Basel, Basel, Switzerland
| | - Bernhard Gerber
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Veronika Baettig
- Division of Infectious Diseases and Hospital Epidemiology, University and University Hospital of Basel, Basel, Switzerland
| | - Maja Weisser
- Division of Infectious Diseases and Hospital Epidemiology, University and University Hospital of Basel, Basel, Switzerland
| | - Sabine Gerull
- Division of Hematology, University Hospital of Basel, Basel, Switzerland
| | - Michael Medinger
- Division of Hematology, University Hospital of Basel, Basel, Switzerland
| | - Jakob Passweg
- Division of Hematology, University Hospital of Basel, Basel, Switzerland
| | - Urs Schanz
- Division of Hematology, University and University Hospital of Zurich, Zurich, Switzerland
| | - Christian Garzoni
- Clinic of Internal Medicine and Infectious Diseases, Clinica Luganese, Lugano, Switzerland.,Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christoph Berger
- Division of Infectious Diseases and Hospital Epidemiology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Yves Chalandon
- Division of Hematology, University Hospital of Geneva, Geneva, Switzerland
| | - Nicolas J Mueller
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, Zurich, Switzerland
| | - Christian van Delden
- Transplant Infectious Diseases Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - Dionysios Neofytos
- Transplant Infectious Diseases Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University and University Hospital of Basel, Basel, Switzerland
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Zhu Y, Gao Q, Du J, Hu J, Liu X, Zhang F. Effects of post-remission chemotherapy before allo-HSCT for acute myeloid leukemia during first complete remission: a meta-analysis. Ann Hematol 2018; 97:1519-1526. [PMID: 29946906 DOI: 10.1007/s00277-018-3414-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 06/21/2018] [Indexed: 10/28/2022]
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is most frequently used to treat acute myeloid leukemia (AML). Whether patients should routinely receive consolidation chemotherapy before proceeding to transplant after achieving first complete remission (CR1) has been a subject of debate. We performed a systematic review and meta-analysis of studies examining the impact of post-remission chemotherapy before allo-HSCT in patients with AML in CR1. Six studies including 1659 patients were included in the meta-analysis. The pooled hazard ratio (HR) for overall survival was 0.9 (95% confidence interval [CI] 0.77-1.05, P = 0.182), and the pooled HR for leukemia-free survival was 0.87 (95% CI 0.75-1.0, P = 0.07). No survival advantage was observed for post-remission chemotherapy before reduced-intensity conditioning or myeloablative conditioning (MAC) allo-HSCT for AML in CR1. The pooled relative risk for relapse incidence (RI) was 1.02 (95% CI 0.82-1.28, P = 0.834). Post-remission chemotherapy before allo-HSCT did not significantly affect the RI in patients with AML in CR1. The analyses revealed no significant benefit of post-remission consolidation chemotherapy in patients who received allo-HSCT. We recommend proceeding to allo-HSCT as soon as CR1 is attained.
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Affiliation(s)
- Yangmin Zhu
- Department of Therapeutic Centre of Anemia, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College (CAMS & PUMC), Tianjin, People's Republic of China
| | - Qingyan Gao
- Department of Therapeutic Centre of Anemia, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College (CAMS & PUMC), Tianjin, People's Republic of China
| | - Jun Du
- Department of Therapeutic Centre of Anemia, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College (CAMS & PUMC), Tianjin, People's Republic of China
| | - Jing Hu
- Department of Therapeutic Centre of Anemia, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College (CAMS & PUMC), Tianjin, People's Republic of China
| | - Xu Liu
- Department of Therapeutic Centre of Anemia, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College (CAMS & PUMC), Tianjin, People's Republic of China
| | - Fengkui Zhang
- Department of Therapeutic Centre of Anemia, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College (CAMS & PUMC), Tianjin, People's Republic of China.
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Bone marrow versus peripheral blood as a graft source for haploidentical donor transplantation in adults using post-transplant cyclophosphamide-A systematic review and meta-analysis. Crit Rev Oncol Hematol 2018; 133:120-128. [PMID: 30661648 DOI: 10.1016/j.critrevonc.2018.05.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/04/2018] [Accepted: 05/24/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Peripheral-blood (PB) and bone marrow (BM) are both widely used in hematopoietic stem cell transplantation (HSCT). However, it is unclear whether PB or BM produces a more satisfactory outcome in haploidentical HSCT, particularly for patients using post-transplant cyclophosphamide (PTCy), which is the standard therapy. However, to date, no meta-analysis focusing on this issue has been published. METHODS We systematically searched PubMed, MEDLINE, Web of Science, the Cochrane Library and the ClinicalTrials.gov website for studies regarding the use of BM or PB in haploidentical HSCT for hematological malignancies in adults using PTCy. Data were analyzed using Open Meta-Analyst statistical software. RESULTS Fourteen studies were extracted including four comparative retrospective reports and ten single-arm reports, with a total of 1759 patients received PTCy haploidentical HSCT (462 patients received PBSCT, 1297 patients received BMT). The pooled outcomes of comparative retrospective studies showed significantly higher incidence of grade III-IV acute graft-versus-host disease (GVHD) (OR = 1.741, 95%CI 1.032-2.938), incidence of grade IIIV acute GVHD (OR = 1.778, 95%CI 1.314, 2.406) and engraftment rate (OR = 1.843, 95%CI 1.066-3.185) in the PB group. No significant differences were found on the incidence of relapse, 2-year overall survival (OS) and disease-free survival (DFS), acute IIIV GVHD and chronic GVHD between PBSCT or BMT. CONCLUSION The efficacy of PB is not inferior to BM for patients undergoing PTCy haploidentical HSCT with regard to primary outcomes, including OS, DFS, NRM and relapse. However, with regards to convenience and pain relief, PB graft is suitable for haploidentical HSCT, but with a higher risk of acute GVHD.
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14
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Lemos NE, Farias MG, Kubaski F, Scotti L, Onsten TGH, Brondani LDA, Wagner SC, Sekine L. Quantification of peripheral blood CD34 + cells prior to stem cell harvesting by leukapheresis: a single center experience. Hematol Transfus Cell Ther 2018; 40:213-218. [PMID: 30128429 PMCID: PMC6098175 DOI: 10.1016/j.htct.2018.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 01/30/2018] [Indexed: 11/30/2022] Open
Abstract
Background Due to laboratory logistic issues, our center has traditionally scheduled peripheral blood stem cell harvests based on timing from the start of mobilization. This has proved to be useful in some cases, but also resulted in many fruitless harvests due to poor mobilization. In order to improve the efficiency of collections and compare the effectiveness of peripheral blood CD34+ cells as a predictor with data from other reports, this study analyzed the implementation of this routine. Methods Peripheral blood and leukapheresis samples were quantified by flow cytometry and the association between these parameters was assessed. Results Sixty-six consecutive leukapheresis samples were collected from 34 patients after the collection of peripheral blood samples for CD34+ quantification. A moderate positive correlation was observed between peripheral blood CD34+ cell count and total CD34+ cell count/kg (r = 0.596; p-value < 0.001). A multivariable regression model also confirmed this association and allowed the estimation that for every increase in five CD34+ cells/μL in the peripheral blood, a mean increase of 0.38 × 106 CD34+ cells/kg could be predicted. Demographic characteristics, baseline comorbidities and mobilization regimen did not influence final CD34+ cell count in this sample. Conclusions As observed in other centers, quantification of peripheral blood CD34+ progenitor cells is a strong predictor of effectiveness to guide stem cell harvesting. Due to the results of this study, a modification in the peripheral blood stem cell harvesting logistics was implemented at our center in order to incorporate this routine.
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Affiliation(s)
- Natália Emerim Lemos
- Universidade Feevale, Novo Hamburgo, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
| | | | - Francyne Kubaski
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | - Luciana Scotti
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
| | | | | | - Sandrine Comparsi Wagner
- Universidade Feevale, Novo Hamburgo, RS, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Leo Sekine
- Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
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15
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Suárez-González J, Martínez-Laperche C, Kwon M, Balsalobre P, Carbonell D, Chicano M, Rodríguez-Macías G, Serrano D, Gayoso J, Díez-Martín JL, Buño I. Donor Cell-Derived Hematologic Neoplasms after Hematopoietic Stem Cell Transplantation: A Systematic Review. Biol Blood Marrow Transplant 2018; 24:1505-1513. [PMID: 29410295 DOI: 10.1016/j.bbmt.2018.01.033] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 01/25/2018] [Indexed: 02/07/2023]
Abstract
Development of de novo hematologic malignancies in donor cells after allogeneic stem cell transplantation (allo-SCT) provides a useful in vivo model to study the process of leukemogenesis. A systematic analysis of the cases reported in the literature was performed to identify risk factors and mechanisms involved in the pathogenesis of donor cell-derived hematologic neoplasms (DCHN) and leukemogenic transformation. Relevant data were extracted from 137 cases. Cases of DCHN show a wide heterogeneity with regard to recipient/donor age, sex mismatch, and conditioning regimen. Some characteristics, such as the type of primary disease, the type of hematologic malignancy of the DCHN, and the stem cell source used in the transplant procedure, differ from those expected. Mechanisms involved in the pathogenesis of DCHN are complex, and several hypotheses have been proposed, such as pre-existing hematologic neoplasms or premalignant clones in the donor, decreased immune surveillance, and damage to bone marrow microenvironment in the recipient. Most likely several if not all these mechanisms play a role in DCHN development. Novel approaches, such as next-generation sequencing to study consecutive samples after allo-SCT in these patients, appear to be promising to decipher the mechanisms of leukemogenesis.
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Affiliation(s)
- Julia Suárez-González
- Genomics Unit, Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain
| | - Carolina Martínez-Laperche
- Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain.
| | - Mi Kwon
- Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Pascual Balsalobre
- Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Diego Carbonell
- Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - María Chicano
- Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
| | | | - David Serrano
- Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - Jorge Gayoso
- Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - José Luis Díez-Martín
- Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain; Department of Medicine, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Ismael Buño
- Genomics Unit, Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Translational Oncology, Gregorio Marañón Health Research Institute, Madrid, Spain; Department of Hematology, Gregorio Marañón General University Hospital, Madrid, Spain
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16
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Khalil MMI, Lipton JH, Atenafu EG, Gupta V, Kim DD, Kuruvilla J, Viswabandya A, Messner HA, Michelis FV. Impact of comorbidities constituting the hematopoietic cell transplant (HCT)-comorbidity index on the outcome of patients undergoing allogeneic HCT for acute myeloid leukemia. Eur J Haematol 2017; 100:198-205. [DOI: 10.1111/ejh.13000] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Manar M. I. Khalil
- Allogeneic Blood and Marrow Transplant Program; Princess Margaret Cancer Centre; University Health Network; University of Toronto; Toronto ON Canada
| | - Jeffrey H. Lipton
- Allogeneic Blood and Marrow Transplant Program; Princess Margaret Cancer Centre; University Health Network; University of Toronto; Toronto ON Canada
| | - Eshetu G. Atenafu
- Department of Biostatistics; Princess Margaret Cancer Centre; University Health Network; University of Toronto; Toronto ON Canada
| | - Vikas Gupta
- Allogeneic Blood and Marrow Transplant Program; Princess Margaret Cancer Centre; University Health Network; University of Toronto; Toronto ON Canada
| | - Dennis D. Kim
- Allogeneic Blood and Marrow Transplant Program; Princess Margaret Cancer Centre; University Health Network; University of Toronto; Toronto ON Canada
| | - John Kuruvilla
- Allogeneic Blood and Marrow Transplant Program; Princess Margaret Cancer Centre; University Health Network; University of Toronto; Toronto ON Canada
| | - Auro Viswabandya
- Allogeneic Blood and Marrow Transplant Program; Princess Margaret Cancer Centre; University Health Network; University of Toronto; Toronto ON Canada
| | - Hans A. Messner
- Allogeneic Blood and Marrow Transplant Program; Princess Margaret Cancer Centre; University Health Network; University of Toronto; Toronto ON Canada
| | - Fotios V. Michelis
- Allogeneic Blood and Marrow Transplant Program; Princess Margaret Cancer Centre; University Health Network; University of Toronto; Toronto ON Canada
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17
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Lemos NE, Farias MG, Kubaski F, Scotti L, Onsten TGH, Brondani LDA, Wagner SC, Sekine L. WITHDRAWN: Quantification of peripheral blood CD34+ cells prior to stem cell harvesting by leukapheresis: a single center experience. Rev Bras Hematol Hemoter 2017. [DOI: 10.1016/j.bjhh.2017.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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18
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Factors affecting hematopoietic stem cell mobilization and apheresis in allogeneic donors: The role of iron status. Transfus Apher Sci 2017. [PMID: 28647301 DOI: 10.1016/j.transci.2017.05.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Infused CD34 cell count has a significant impact on transplant outcome. In this retrospective study, we aimed to analyze the impact of donor iron parameters on peripheral blood stem cell (PBSC) collection. A total of 303 related donors were included in the study. The mobilization regimen, recombinant G-CSF, was given for four consecutive days. A CD34+ cell count below 2×106/kg was defined as mobilization failure which was demonstrated in 23 donors (7.6%). Mobilization failure was more frequent in female donors than male donors (13.7% vs 3.4%). Body mass index, mean corpuscular volume, hemoglobin and ferritin levels were found to be lower in donors with mobilization failure. Body mass index was significantly correlated with PBSC count on the 4th day of G-CSF. Body mass index, male gender, mean corpuscular volume and ferritin levels had significant impact on PBSC count. Although PBSC count was found to be similar between female and male donors, female gender was shown to have an adverse impact on PBSC collection, which may be attributed to lower body weight and concurrent iron deficiency.
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19
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Khandelwal P, Millard HR, Thiel E, Abdel-Azim H, Abraham AA, Auletta JJ, Boulad F, Brown VI, Camitta BM, Chan KW, Chaudhury S, Cowan MJ, Angel-Diaz M, Gadalla SM, Gale RP, Hale G, Kasow KA, Keating AK, Kitko CL, MacMillan ML, Olsson RF, Page KM, Seber A, Smith AR, Warwick AB, Wirk B, Mehta PA. Hematopoietic Stem Cell Transplantation Activity in Pediatric Cancer between 2008 and 2014 in the United States: A Center for International Blood and Marrow Transplant Research Report. Biol Blood Marrow Transplant 2017; 23:1342-1349. [PMID: 28450183 DOI: 10.1016/j.bbmt.2017.04.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 04/19/2017] [Indexed: 12/26/2022]
Abstract
This Center for International Blood and Marrow Transplant Research report describes the use of hematopoietic stem cell transplantation (HSCT) in pediatric patients with cancer, 4408 undergoing allogeneic (allo) and3076 undergoing autologous (auto) HSCT in the United States between 2008 and 2014. In both settings, there was a greater proportion of boys (n = 4327; 57%), children < 10 years of age (n = 4412; 59%), whites (n = 5787; 77%), and children with a performance score ≥ 90% at HSCT (n = 6187; 83%). Leukemia was the most common indication for an allo-transplant (n = 4170; 94%), and among these, acute lymphoblastic leukemia in second complete remission (n = 829; 20%) and acute myeloid leukemia in first complete remission (n = 800; 19%) werethe most common. The most frequently used donor relation, stem cell sources, and HLA match were unrelated donor (n = 2933; 67%), bone marrow (n = 2378; 54%), and matched at 8/8 HLA antigens (n = 1098; 37%) respectively. Most allo-transplants used myeloablative conditioning (n = 4070; 92%) and calcineurin inhibitors and methotrexate (n = 2245; 51%) for acute graft-versus-host disease prophylaxis. Neuroblastoma was the most common primary neoplasm for an auto-transplant (n = 1338; 44%). Tandem auto-transplants for neuroblastoma declined after 2012 (40% in 2011, 25% in 2012, and 8% in 2014), whereas tandem auto-transplants increased for brain tumors (57% in 2008 and 77% in 2014). Allo-transplants from relatives other than HLA-identical siblings doubled between 2008 and 2014 (3% in 2008 and 6% in 2014). These trends will be monitored in future reports of transplant practices in the United States.
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Affiliation(s)
- Pooja Khandelwal
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Heather R Millard
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Elizabeth Thiel
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Hisham Abdel-Azim
- Division of Hematology, Oncology and Blood & Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Allistair A Abraham
- Division of Blood and Marrow Transplantation, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC
| | - Jeffery J Auletta
- Host Defense Program, Divisions of Hematology/Oncology/Bone Marrow Transplant and Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio
| | - Farid Boulad
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Valerie I Brown
- Division of Pediatric Oncology/Hematology, Department of Pediatrics, Penn State Hershey Children's Hospital, College of Medicine, Hershey, Pennsylvania
| | - Bruce M Camitta
- Midwest Center for Cancer and Blood Disorders, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, Wisconsin
| | - Ka Wah Chan
- Department of Pediatrics, Texas Transplant Institute, San Antonio, Texas
| | - Sonali Chaudhury
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Morton J Cowan
- Pediatric Allergy Immunology and Blood and Marrow Transplant Division, UCSF Benioff Children's Hospital, San Francisco, California
| | - Miguel Angel-Diaz
- Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Shahinaz M Gadalla
- Division of Cancer Epidemiology & Genetics, NIH-NCI Clinical Genetics Branch, Rockville, Maryland
| | - Robert Peter Gale
- Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - Gregory Hale
- Department of Hematology/Oncology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida
| | - Kimberly A Kasow
- Division of Hematology-Oncology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Amy K Keating
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Carrie L Kitko
- Pediatric Hematology/Oncology Division, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Margaret L MacMillan
- University of Minnesota, Blood and Marrow Transplant Program, Minneapolis, Minnesota
| | - Richard F Olsson
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden; Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - Kristin M Page
- Division of Pediatric Blood and Marrow Transplantation, Duke University Medical Center, Durham, North Carolina
| | - Adriana Seber
- Internal Medicine, University of Sao Paulo School of Medicine, Sau Paulo, Brazil
| | - Angela R Smith
- University of Minnesota, Blood and Marrow Transplant Program, Minneapolis, Minnesota
| | - Anne B Warwick
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Baldeep Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, Washington
| | - Parinda A Mehta
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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20
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Halagan M, Manor S, Shriki N, Yaniv I, Zisser B, Madbouly A, Maiers M, Stein J. East Meets West-Impact of Ethnicity on Donor Match Rates in the Ezer Mizion Bone Marrow Donor Registry. Biol Blood Marrow Transplant 2017; 23:1381-1386. [PMID: 28396163 DOI: 10.1016/j.bbmt.2017.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 04/05/2017] [Indexed: 11/24/2022]
Abstract
HLA haplotype frequencies in a volunteer bone marrow donor registry should reflect the frequencies of potential transplant recipients served by that registry, a challenge in a country with diverse subethnicities of immigrants from Eastern and Western cultures, such as Israel. We evaluated the likelihood of finding suitable donors for hypothetical patients drawn from defined subethnicities in the Ezer Mizion Bone Marrow Donor Registry (EM BMDR) from donors both within and outside the registry now and during the coming decade. On average, bioinformatics modeling predicts that, given current donor recruitment trends, 6/6 high-resolution HLA match rates for Israelis, which currently stand at 40% to 55% for most subethnicities, will rise by up to 1% per year over the next decade. Subethnicities with historically lower rates of interethnic admixture are less likely to find matches outside of their designated group but will benefit from expansion of the registry, whereas ethnically directed drives will enhance matching rates for currently underrepresented subethnicities. Donor searches for the same cohort using a large extramural registry was of only slight benefit for most of the 19 EM BMDR subethnicities evaluated, confirming that local donor registries that reflect the ethnic diversity of the community being served are best equipped to serve the needs of their respective communities. Contemporary trends of an increasingly multiethnic admixture in Israel may impact the effect of ethnic profiling in assessing future match rates for EM BMDR.
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Affiliation(s)
- Michael Halagan
- Bioinformatics Research, National Marrow Donor Program, Minneapolis, Minnesota.
| | - Sigal Manor
- Ezer Mizion Bone Marrow Donor Registry, Petah-Tikva, Israel
| | - Nira Shriki
- Ezer Mizion Bone Marrow Donor Registry, Petah-Tikva, Israel
| | - Isaac Yaniv
- Ezer Mizion Bone Marrow Donor Registry, Petah-Tikva, Israel; Bone Marrow Transplant Unit, Schneider Children's Medical Center of Israel, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Bracha Zisser
- Ezer Mizion Bone Marrow Donor Registry, Petah-Tikva, Israel
| | - Abeer Madbouly
- Bioinformatics Research, National Marrow Donor Program, Minneapolis, Minnesota
| | - Martin Maiers
- Bioinformatics Research, National Marrow Donor Program, Minneapolis, Minnesota
| | - Jerry Stein
- Bone Marrow Transplant Unit, Schneider Children's Medical Center of Israel, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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21
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Hussein AA, Hamidieh AA, Elhaddad A, Ramzi M, Othman TB, Hussain F, Dennison D, Ahmed P, Abboud M, Al-Ahmari A, Wahadneh A, Fathy J, Bekadja MA, Al-Kindi S, Benchekroun S, Ibrahim A, Behfar M, Samra M, Ladeb S, Adil S, El-Solh H, Ayas M, Aljurf M, Ghavamzadeh A, Al-Seraihy A. First report of pediatric hematopoietic stem cell transplantation activities in the eastern mediterranean region from 1984 to 2011: on behalf of the pediatric cancer working committee of the eastern mediterranean blood and marrow transplantation group. Bone Marrow Transplant 2016; 52:120-125. [PMID: 27618684 DOI: 10.1038/bmt.2016.209] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 07/02/2016] [Accepted: 07/11/2016] [Indexed: 12/18/2022]
Abstract
To describe the hematopoietic stem cell transplantation (HSCT) activities for children in the Eastern Mediterranean (EM) region, data on transplants performed for children less than 18 years of age between 1984 and 2011 in eight EM countries (Egypt, Iran, Jordan, Lebanon, Oman, Pakistan, Saudi Arabia and Tunisia) were collected. A total of 5187 transplants were performed, of which 4513 (87%) were allogeneic and 674 (13%) were autologous. Overall, the indications for transplantation were malignant diseases in 1736 (38.5%) and non-malignant in 2777 (61.5%) patients. A myeloablative conditioning regimen was used in 88% of the allografts. Bone marrow (BM) was the most frequent source of stem cells (56.2%), although an increasing use of PBSC was observed in the last decade. The stem cell source of autologous HSCT has shifted over time from BM to PBSC, and 80.9% of autologous HSCTs were from PBSCs. The donors for allogeneic transplants were matched-related in 94.5% of the cases, and unrelated transplants, mainly cord blood (99%) in 239 (5.5%) cases. This is the first report to describe the pediatric HSCT activities in EM countries. Non-malignant disorders are the main indication for allogeneic transplantation. Frequency of alternate donor transplantation is low.
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Affiliation(s)
- A A Hussein
- Bone Marrow and Stem Cell Transplantation Program, King Hussein Cancer Center, Amman, Jordan
| | - A A Hamidieh
- Hematology, Oncology and SCT Research Center, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - A Elhaddad
- National Cancer Institute, Cairo University, Cairo, Egypt
| | - M Ramzi
- Shiraz University of Medical Science, Shiraz, Islamic Republic of Iran
| | - T B Othman
- Center National de Greffe de Moelle Osseuse de Tunis, Tunis, Tunisia
| | - F Hussain
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - D Dennison
- Sultan Qaboos University Hospital, Muscat, Oman
| | - P Ahmed
- Armed Forces Bone Marrow Transplant Center, Rawalpindi, Pakistan
| | - M Abboud
- American University Beirut Medical Center, Beirut, Lebanon
| | - A Al-Ahmari
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - A Wahadneh
- Queen Rania Al-Abdullah Children Hospital-King Hussein Medical Center, Amman, Jordan
| | - J Fathy
- National Cancer Institute, Cairo University, Cairo, Egypt
| | - M-A Bekadja
- Oran University-1st November Hospital, Oran, Algeria
| | - S Al-Kindi
- Sultan Qaboos University Hospital, Muscat, Oman
| | - S Benchekroun
- Service d'Hematologie et Oncologie Pediatrique, Casablanca, Morocco
| | - A Ibrahim
- Makassed General Hospital, Beirut, Lebanon
| | - M Behfar
- Hematology, Oncology and SCT Research Center, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - M Samra
- National Cancer Institute, Cairo University, Cairo, Egypt
| | - S Ladeb
- Center National de Greffe de Moelle Osseuse de Tunis, Tunis, Tunisia
| | - S Adil
- Aga Khan University Hospital, Karachi, Pakistan
| | - H El-Solh
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - M Ayas
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - M Aljurf
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - A Ghavamzadeh
- Hematology, Oncology and SCT Research Center, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - A Al-Seraihy
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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22
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Striving to cure adult T-cell leukaemia/lymphoma: a role for allogeneic stem cell transplant? Bone Marrow Transplant 2016; 51:1549-1555. [PMID: 27618683 DOI: 10.1038/bmt.2016.154] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 04/18/2016] [Accepted: 04/22/2016] [Indexed: 11/09/2022]
Abstract
Adult T-cell leukaemia/lymphoma (ATL) is an aggressive HTLV-1-related malignancy, rare outside of regions where the retrovirus is endemic. Although the use of antiviral therapy has improved outcomes, particularly for indolent forms of ATL, response to combination chemotherapy is poor and outcomes for aggressive subtypes remains dismal. Consolidation with allogeneic stem cell transplant (alloSCT) has an increasing role in the management of ATL in eligible patients, offering favourable long-term remission rates. However, relatively high-transplant-related mortality and issues with donor recruitment for certain ethnicities remain problematic. In this review, we discuss the rationale for and issues surrounding alloSCT in ATL in the context of conventional and emerging therapies.
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23
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Zhou M, Zheng Y, Ma S, Zhou D, Li L, Zhu J, Zhu L, Yang X, Luo Y, Huang H, Ye X, Xie W. Clinical Observation on Hemogram Variation of Allogeneic Donors from Chinese Population for Peripheral Hematopoietic Stem Cell Collection. Stem Cells Dev 2016; 25:798-802. [PMID: 26985857 DOI: 10.1089/scd.2016.0017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Meng Zhou
- 1 Department of Hematology, the First Affiliated Hospital of Medical School of Zhejiang University , Hangzhou, China
| | - Yanlong Zheng
- 1 Department of Hematology, the First Affiliated Hospital of Medical School of Zhejiang University , Hangzhou, China
| | - Shanshan Ma
- 1 Department of Hematology, the First Affiliated Hospital of Medical School of Zhejiang University , Hangzhou, China
| | - De Zhou
- 1 Department of Hematology, the First Affiliated Hospital of Medical School of Zhejiang University , Hangzhou, China
| | - Li Li
- 1 Department of Hematology, the First Affiliated Hospital of Medical School of Zhejiang University , Hangzhou, China
| | - Jingjing Zhu
- 1 Department of Hematology, the First Affiliated Hospital of Medical School of Zhejiang University , Hangzhou, China
| | - Lixia Zhu
- 1 Department of Hematology, the First Affiliated Hospital of Medical School of Zhejiang University , Hangzhou, China
| | - Xiudi Yang
- 1 Department of Hematology, the First Affiliated Hospital of Medical School of Zhejiang University , Hangzhou, China
| | - Yi Luo
- 2 Bone Marrow Transplantation Center, the First Affiliated Hospital of Medical School of Zhejiang University , Hangzhou, China
| | - He Huang
- 2 Bone Marrow Transplantation Center, the First Affiliated Hospital of Medical School of Zhejiang University , Hangzhou, China
| | - Xiujin Ye
- 1 Department of Hematology, the First Affiliated Hospital of Medical School of Zhejiang University , Hangzhou, China
| | - Wanzhuo Xie
- 1 Department of Hematology, the First Affiliated Hospital of Medical School of Zhejiang University , Hangzhou, China
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Bunse CE, Tischer S, Lahrberg J, Oelke M, Figueiredo C, Blasczyk R, Eiz-Vesper B. Granulocyte colony-stimulating factor impairs CD8(+) T cell functionality by interfering with central activation elements. Clin Exp Immunol 2016; 185:107-18. [PMID: 26990855 DOI: 10.1111/cei.12794] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2016] [Indexed: 12/17/2022] Open
Abstract
Besides mobilizing stem cells into the periphery, granulocyte colony-stimulating factor (G-CSF) has been shown to influence various types of innate and adaptive immune cells. For example, it impairs the effector function of cytotoxic T lymphocytes (CTLs). It is assumed that this effect is mediated indirectly by monocytes, regulatory T cells and immunomodulatory cytokines influenced by G-CSF. In this study, isolated G-CSF-treated CD8(+) T cells were stimulated antigen-dependently with peptide-major histocompatibility complex (pMHC)-coupled artificial antigen-presenting cells (aAPCs) or stimulated antigen-independently with anti-CD3/CD28 stimulator beads. By measuring the changes in interferon (IFN)-γ and granzyme B expression at the mRNA and protein level, we showed for the first time that G-CSF has a direct effect on CD8(+) CTLs, which was confirmed based on the reduced production of IFN-γ and granzyme B by the cytotoxic T cell line TALL-104 after G-CSF treatment. By investigating further elements affected by G-CSF in CTLs from stem cell donors and untreated controls, we found a decreased phosphorylation of extracellular-regulated kinase (ERK)1/2, lymphocyte-specific protein tyrosine kinase (Lck) and CD3ζ after G-CSF treatment. Additionally, miRNA-155 and activation marker expression levels were reduced. In summary, our results show that G-CSF directly influences the effector function of cytotoxic CD8(+) T cells and affects various elements of T cell activation.
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Affiliation(s)
- C E Bunse
- Institute for Transfusion Medicine.,Integrated Research and Treatment Centre Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany
| | - S Tischer
- Institute for Transfusion Medicine.,Integrated Research and Treatment Centre Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany
| | | | - M Oelke
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - R Blasczyk
- Institute for Transfusion Medicine.,Integrated Research and Treatment Centre Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany
| | - B Eiz-Vesper
- Institute for Transfusion Medicine.,Integrated Research and Treatment Centre Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany
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25
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Adhikari J, Sharma P, Bhatt VR. Optimal graft source for allogeneic hematopoietic stem cell transplant: bone marrow or peripheral blood? Future Oncol 2016; 12:1823-32. [PMID: 27168462 DOI: 10.2217/fon-2016-0106] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Peripheral blood (PB), compared with bone marrow graft, has higher stem cell content, leads to faster engraftment and is more convenient for collection. Consequently, the use of PB graft has significantly increased in recent years. Although the use of PB graft is acceptable or even preferred to bone marrow graft in matched related donor allogeneic transplant due to a possibility of improved survival, PB graft increases the risk of chronic graft-versus-host disease and associated long-term toxicities in the setting of matched unrelated donor allogeneic transplant. In haploidentical transplant, mitigation of graft-versus-host disease with the use of post-transplant cyclophosphamide is a hypothesis-generating possibility; however, available studies have significant limitations to draw any definite conclusion.
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Affiliation(s)
- Janak Adhikari
- Department of Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - Priyadarshani Sharma
- Department of Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - Vijaya Raj Bhatt
- Department of Internal Medicine, Division of Hematology-Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA
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26
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Zhou P, Liu P, Zhou SY, He XH, Han XH, Qin Y, Yang S, Zhang CG, Gui L, Yao JR, Zhao LY, Zhang SX, Sun Y, Shi YK. Ifosfamide, Cisplatin or Carboplatin, and Etoposide (ICE)-based Chemotherapy for Mobilization of Autologous Peripheral Blood Stem Cells in Patients with Lymphomas. Chin Med J (Engl) 2016; 128:2498-504. [PMID: 26365969 PMCID: PMC4725560 DOI: 10.4103/0366-6999.164936] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is a promising approach for lymphomas. This study aimed to evaluate the effect of ifosfamide, cisplatin or carboplatin, and etoposide (ICE)-based regimen as a mobilization regimen on relapsed, refractory, or high-risk aggressive lymphoma. Methods: From June 2001 to May 2013, patients with lymphomas who mobilized by ICE-based regimen for ASCT were analyzed in this retrospective study. The results of the autologous peripheral blood stem cells collection, toxicity, engraftment after ICE-based mobilization regimen were analyzed in this study. Furthermore, risk factors for overall survival (OS) and progression free survival (PFS) were evaluated by univariate analysis. Results: The stem cells were mobilized using ICE-based regimen plus rituximab or ICE-based regimen alone in 12 patients and 54 patients, respectively. The results of stem cell mobilization were excellent. Ninety-seven percentages of the patients had the stem cell collection of at least 2.0 × 106 CD34+ cells/kg and 68% had at least 5 × 106 CD34+ cells/kg. Fifty-eight percentage of the patients experienced Grade 4 neutropenia, 20% developed febrile neutropenia, and only 12% had Grade 4 thrombocytopenia. At a median follow-up of 63.8 months, the 5-year PFS and OS were 64.4% and 75.3%, respectively. Conclusion: ICE is a powerful regimen for stem cell mobilization in patients with lymphomas.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Yuan-Kai Shi
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing 100021, China
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27
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[Short-term effects of hemogram in healthy donors after peripheral blood stem cell collection]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2016; 36:1011-5. [PMID: 26759103 PMCID: PMC7342316 DOI: 10.3760/cma.j.issn.0253-2727.2015.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
目的 探讨连续外周血造血干细胞(PBSC)采集对异基因造血干细胞供者外周血细胞计数的影响以及供者对连续采集的耐受性。 方法 166名于2013至2014年在浙江大学医学院附属第一医院血液科捐献PBSC的亲缘异基因供者,男86名,女80名,中位年龄40.5(15.0~60.0)岁。动员方案为G-CSF 5~10 µg·kg−1·d−1皮下注射至采集结束。于PBSC动员前、采集前、采集1次及2次后检测供者外周血以及采集物中WBC、PLT、HGB。 结果 连续2次PBSC采集后供者外周血HGB中位数由145(94~181)g/L降至138(93~167)g/L(P<0.05),PLT中位数由231(105~490)×109/L降至95(39~210)× 109/L(P<0.05),WBC差异无统计学意义(P>0.05)。采集物中HGB与供者外周血HGB降幅呈低度正相关(r=0.297,P=0.017),采集物中PLT与供者外周血PLT降幅高度相关(r=0.719,P<0.001)。不同年龄组供者在PBSC采集后的HGB降幅两两比较差异无统计学意义(P≥0.05)。PLT差异无统计学意义(P>0.05)。不同体重指数供者在PBSC采集1次及2次后外周血HGB降幅差异均有统计学意义(P=0.003,P<0.001),体重指数<18.5 kg/m2的偏瘦组供者HGB下降最明显(P<0.05)。 结论 健康异基因造血干细胞供者在连续PBSC采集过程中HGB轻度下降,对于偏瘦供者应调整采集参数以保证安全。采集PBSC会使血小板减少的风险增加,减少的程度与年龄及体重指数无关,且均可耐受。
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28
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Porter JB, de Witte T, Cappellini MD, Gattermann N. New insights into transfusion-related iron toxicity: Implications for the oncologist. Crit Rev Oncol Hematol 2015; 99:261-71. [PMID: 26806144 DOI: 10.1016/j.critrevonc.2015.11.017] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 09/28/2015] [Accepted: 11/24/2015] [Indexed: 01/19/2023] Open
Abstract
Iron overload is a potentially life-threatening consequence of multiple red-blood-cell transfusions. Here, we review factors affecting excess iron distribution and its damage to specific tissues, as well as mechanisms of oncogenesis by iron. Although consequences of transfusional iron overload are best described in thalassemia major and related inherited anemias, they are increasingly recognized in acquired conditions, such as myelodysplastic syndromes (MDS). Iron overload in MDS not only impacts on certain tissues, but may affect the clonal evolution of MDS through generation of reactive oxygen species. Iron overload may also influence hematopoietic-stem-cell-transplantation outcomes. Novel MRI methods for assessing body iron have impacted significantly on outcome in inherited anemias by allowing monitoring of iron burden and iron chelation therapy. This approach is increasingly being used in MDS and stem-cell-transplant procedures. Knowledge gained from managing transfusional iron overload in inherited anemias may be translated to general oncology, with potential for improved patient outcomes.
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Affiliation(s)
- John B Porter
- Department of Haematology, University College London, UCL Cancer Institute, Paul O'Gorman Building, 72 Huntley Street, London WC1E 6BT, UK.
| | - Theo de Witte
- Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
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29
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Kuwatsuka Y. Quality control and assurance in hematopoietic stem cell transplantation data registries in Japan and other countries. Int J Hematol 2015; 103:20-4. [DOI: 10.1007/s12185-015-1896-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 10/29/2015] [Accepted: 11/04/2015] [Indexed: 11/28/2022]
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30
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Worel N. ABO-Mismatched Allogeneic Hematopoietic Stem Cell Transplantation. Transfus Med Hemother 2015; 43:3-12. [PMID: 27022317 DOI: 10.1159/000441507] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 07/06/2015] [Indexed: 12/19/2022] Open
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative option for a variety of malignant and non-malignant hematological and congenital diseases. Due to the fact that the human leukocyte antigen system is inherited independently of the blood group system, approximately 40-50% of all HSCTs are performed across the ABO blood group barrier. The expected immune-hematological consequences after transplantation of an ABO-mismatched stem cell graft are immediate and delayed hemolytic complications due to presence of isohemagglutinins or passenger lymphocyte syndrome. The risks of these complications can partially be prevented by graft manipulation and appropriate transfusion support. Dependent on the kind of ABO mismatch, different effects on engraftment have been observed, e.g. delayed red blood cell recovery and pure red cell aplasia. Data on incidence of acute graft-versus-host disease (GVHD), non-relapse mortality, relapse, and overall survival are inconsistent as most studies include limited patient numbers, various graft sources, and different conditioning and GVHD prophylaxis regimens. This makes it difficult to detect a consistent effect of ABO-mismatched transplantation in the literature. However, knowledge of expectable complications and close monitoring of patients helps to detect problems early and to treat patients efficiently, thus reducing the number of fatal or life-threatening events caused by ABO-mismatched HSCT.
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Affiliation(s)
- Nina Worel
- Department for Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
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31
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Is peripheral blood or bone marrow a better source of stem cells for transplantation in cases of HLA-matched unrelated donors? A meta-analysis. Crit Rev Oncol Hematol 2015; 96:20-33. [DOI: 10.1016/j.critrevonc.2015.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 01/18/2015] [Accepted: 04/30/2015] [Indexed: 12/15/2022] Open
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32
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Nivison-Smith I, Bardy P, Dodds AJ, Ma DDF, Aarons D, Tran S, Wilcox L, Szer J. A Review of Hematopoietic Cell Transplantation in Australia and New Zealand, 2005 to 2013. Biol Blood Marrow Transplant 2015; 22:284-291. [PMID: 26385524 DOI: 10.1016/j.bbmt.2015.09.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 09/09/2015] [Indexed: 12/31/2022]
Abstract
This report describes hematopoietic cell transplantation (HCT) activity and outcome in Australia and New Zealand during the years 2005 to 2013. In 2013, 1018 autologous, 221 allogeneic with related donors, and 264 allogeneic with unrelated donors HCT were performed in 40 centers in Australia, with corresponding figures of 147, 39, and 47 in 6 centers in New Zealand. Annual numbers of HCT in 2013 increased, compared to 2005, by 25% in Australia and by 52% in New Zealand. The majority of both allogeneic and autologous HCT used peripheral blood as the stem cell source for all years studied. Major indications for transplantation were acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), plasma cell disorders, and non-Hodgkin lymphoma (NHL). Overall survival probabilities at 5 years after transplantation for adult (16+) allogeneic first HCT recipients were 54.2% for ALL, 46.0% for AML, 48.4% for myelodysplastic syndromes, and 58.6% for NHL. Consistent patterns over time include a steady increase in HCT, particularly for older recipients, relatively constant numbers of allografts using cord blood, and a recent increase in the number of allografts with 2 or more HLA-mismatched related donors.
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Affiliation(s)
- Ian Nivison-Smith
- Australasian Bone Marrow Transplant Recipient Registry, Darlinghurst, NSW, Australia.
| | - Peter Bardy
- Central Adelaide Local Health Network, South Australia Health, South Australia, Australia
| | - Anthony J Dodds
- Department of Haematology and SCT, St. Vincent's Hospital, Darlinghurst, NSW, Australia
| | - David D F Ma
- Department of Haematology and SCT, St. Vincent's Hospital, Darlinghurst, NSW, Australia
| | - Donna Aarons
- Australasian Bone Marrow Transplant Recipient Registry, Darlinghurst, NSW, Australia
| | - Steven Tran
- Australasian Bone Marrow Transplant Recipient Registry, Darlinghurst, NSW, Australia
| | - Leonie Wilcox
- Australasian Bone Marrow Transplant Recipient Registry, Darlinghurst, NSW, Australia
| | - Jeff Szer
- Department of Haematology and BMT, Royal Melbourne Hospital, Parkville, Victoria, Australia
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33
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Karakukcu M, Unal E. Stem cell mobilization and collection from pediatric patients and healthy children. Transfus Apher Sci 2015; 53:17-22. [PMID: 26116046 DOI: 10.1016/j.transci.2015.05.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Today, hematopoietic stem cell transplantation (HSCT) is a standard treatment for a variety of conditions in children, including certain malignancies, hemoglobinopathies, bone marrow failure syndromes, immunodeficiency and inborn metabolic disease. Two fundamentally different types of HSCT are categorized by the source of the stem cells. The first, autologous HSCT represents infusion of patient's own hematopoietic stem cells (HSCs) obtained from the patient; the second, allogeneic HSCT refers to the infusion of HSCs obtained from a donor via bone marrow harvest or apheresis. Bone marrow has been the typical source for HSCs for pediatric donors. Bone marrow harvest is a safe procedure mainly related to mild and transient side effects. Recently, a dramatically increased use of mobilized peripheral blood stem cells (PBSCs) in the autologous as well as allogeneic setting has been seen worldwide. There are limited data comparing mobilization regimens; also mobilization practices vary widely in children. The most commonly used approach includes granulocyte colony stimulating factor (G-CSF) at 10 mg/kg/day as a single daily dose for 4 days before the day of leukapheresis. G-CSF induced pain was less reported in children compared to adult donors. For the collection, there are several technical problems, derived from the size of the patient or donor, which must be considered before and during the apheresis. Vascular access, extracorporeal circuit volume, blood flow rates are the main limiting factors for PBSC collection in small children. Most children younger than 12 years require central vascular access for apheresis; line placement may require either general anesthesia or conscious sedation and many of the complications arise from the central venous catheter. In this review, we discuss that the ethical considerations and some principals regarding children serving as stem cell donors and the commonest sources of HSCs are presented in children, together with a discussion of how to collect and process these cells.
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Affiliation(s)
- Musa Karakukcu
- Department of Pediatric Hematology and Oncology, Faculty of Medicine, Erciyes Pediatric Stem Cell Transplantation Center, Erciyes University, Kayseri, Turkey.
| | - Ekrem Unal
- Department of Pediatric Hematology and Oncology, Faculty of Medicine, Erciyes Pediatric Stem Cell Transplantation Center, Erciyes University, Kayseri, Turkey
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Chabannon C, Bijou F, Miclea JM, Milpied N, Grouin JM, Mohty M. A nationwide survey of the use of plerixafor in patients with lymphoid malignancies who mobilize poorly demonstrates the predominant use of the "on-demand" scheme of administration at French autologous hematopoietic stem cell transplant programs. Transfusion 2015; 55:2149-57. [PMID: 25968564 DOI: 10.1111/trf.13141] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 03/05/2015] [Accepted: 03/09/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND High-dose chemotherapy supported with autologous stem cell transplantation is a standard therapeutic option for a subset of patients with lymphoid malignancies. Cell procurement is nowadays done almost exclusively through cytapheresis, after mobilization of hematopoietic stem and progenitor cells (HSPCs) from the marrow to peripheral blood (PB). The egress of HSPCs out of hematopoietic niches occurs in various physiologic or nonhomeostatic situations; pharmacologic approaches include the administration of acutely myelosuppressive agents or hematopoietic growth factors such as recombinant human granulocyte-colony-stimulating factor (rHuG-CSF). The introduction of plerixafor, a first-of-its-class molecule that reversibly inhibits the interaction between the chemokine CXCL-12 (also known as SDF-1) and its receptor CXCR-4, has offered new opportunities for the so-called "poor mobilizers" who achieve insufficient mobilization and/or collection with conventional approaches. STUDY DESIGN AND METHODS Because of the lack of consensus on a definition for poor mobilizers and the relatively high cost of plerixafor, French competent authorities have mandated a postmarketing survey on its use in routine practice. RESULTS AND CONCLUSION We report here the results of this nationwide survey that confirms the clinical efficacy of plerixafor, even in the subset of patients who barely increased PB CD34+ cell count in response to rHuG-CSF-containing mobilization regimen. Furthermore, analysis of this registry showed that despite heterogeneity in medical practices, the early-"on-demand" or "preemptive"-introduction of plerixafor was widely used and did not result in an excess of prescriptions, beyond its expected use at the time when marketing authorization was granted.
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Affiliation(s)
- Christian Chabannon
- Institut Paoli-Calmettes, Centre de Lutte Contre le Cancer.,Université d'Aix-Marseille.,Inserm CBT 1409, Centre d'Investigations Cliniques en Biothérapie, Marseille, France
| | - Fontanet Bijou
- Etablissement Français du Sang Aquitaine.,CNRS UMR 5164, CIRID, "Composantes Innées de la Réponse Immunitaire et de la Différenciation,", Bordeaux, France
| | - Jean-Michel Miclea
- Hôpital Saint-Louis, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | - Noel Milpied
- Centre Hospitalier et Universitaire de Bordeaux, Bordeaux, France
| | - Jean-Marie Grouin
- Inserm U657 "Pharmaco-Épidémiologie et Évaluation de l'Impact des Produits de Santé sur les Populations",Université de Rouen, Rouen, France
| | - Mohamad Mohty
- Hôpital Saint Antoine, Assistance Publique des Hôpitaux de Paris (AP-HP).,Université Pierre et Marie Curie (UPMC).,INSERM, UMRs 938, Centre de Recherches Saint-Antoine, Paris, France
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Efficacy of plerixafor in children with malignant tumors failing to mobilize a sufficient number of hematopoietic progenitors with G-CSF. Bone Marrow Transplant 2015; 50:1089-91. [DOI: 10.1038/bmt.2015.71] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 02/17/2015] [Accepted: 03/01/2015] [Indexed: 12/13/2022]
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36
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JC polyomavirus reactivation is common following allogeneic stem cell transplantation and its preemptive detection may prevent lethal complications. Bone Marrow Transplant 2015; 50:984-91. [PMID: 25867649 DOI: 10.1038/bmt.2015.68] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 01/08/2015] [Accepted: 01/09/2015] [Indexed: 01/06/2023]
Abstract
Extended application of allogeneic stem cell transplantation (alloSCT) is expected to increase the frequency of JC polyomavirus (JCPyV)-related progressive multifocal leukoencephalopathy (PML). The aim of this study was to assess frequency, risk factors and course of JCPyV reactivation in allografted hematology patients. This retrospective study included consecutive adult patients, treated with alloSCT between January 2008 and December 2011. Quantitative JCPyV-PCR analysis was performed on whole blood DNA samples, originally drawn for cytomegalovirus detection since transplant date. The study included 164 patients diagnosed with hematological malignancies. Patients received reduced-intensity conditioning (n=74) or myeloablative conditioning (n=90), followed by alloSCT. Twenty patients developed transient and 20 had persistent JCPyV reactivation. Two of the patients with persistent reactivation showed a gradual increase in JCPyV levels, preceding PML development by 96 and 127 days. Cessation of immunosuppression resulted in complete resolution of neurological symptoms in one patient, while the other died of PML. Seventy percent of the 'persistently reactivating' patients died. Multivariate analysis confirmed age to be the only significant predictive factor for JCPyV reactivation. In conclusion, JCPyV reactivation occurs in a quarter of allografted patients. Preemptive detection of JCPyV reactivation in high-risk subjects and early discontinuation of immunosuppressive therapy may prevent development of lethal PML.
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Smagur A, Mitrus I, Ciomber A, Panczyniak K, Fidyk W, Sadus-Wojciechowska M, Holowiecki J, Giebel S. Comparison of the cryoprotective solutions based on human albumin vs. autologous plasma: its effect on cell recovery, clonogenic potential of peripheral blood hematopoietic progenitor cells and engraftment after autologous transplantation. Vox Sang 2015; 108:417-24. [DOI: 10.1111/vox.12238] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 10/15/2014] [Accepted: 11/29/2014] [Indexed: 12/30/2022]
Affiliation(s)
- A. Smagur
- Department of Bone Marrow Transplantation and Oncohematology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch; Gliwice Poland
| | - I. Mitrus
- Department of Bone Marrow Transplantation and Oncohematology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch; Gliwice Poland
| | - A. Ciomber
- Department of Bone Marrow Transplantation and Oncohematology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch; Gliwice Poland
| | - K. Panczyniak
- Analytics and Clinical Biochemistry Department; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch; Gliwice Poland
| | - W. Fidyk
- Department of Bone Marrow Transplantation and Oncohematology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch; Gliwice Poland
| | - M. Sadus-Wojciechowska
- Department of Bone Marrow Transplantation and Oncohematology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch; Gliwice Poland
| | - J. Holowiecki
- Department of Bone Marrow Transplantation and Oncohematology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch; Gliwice Poland
| | - S. Giebel
- Department of Bone Marrow Transplantation and Oncohematology; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch; Gliwice Poland
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Pessach I, Resnick I, Shimoni A, Nagler A. G-CSF-primed BM for allogeneic SCT: revisited. Bone Marrow Transplant 2015; 50:892-8. [DOI: 10.1038/bmt.2015.25] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 01/04/2015] [Accepted: 01/05/2015] [Indexed: 01/08/2023]
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39
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Hematopoietic SCT in Iranian children 1991–2012. Bone Marrow Transplant 2015; 50:517-22. [DOI: 10.1038/bmt.2014.299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 10/26/2014] [Accepted: 11/21/2014] [Indexed: 11/08/2022]
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Seo BY, Choi HW, Kang MG, Cho D, Kee SJ, Kim SH, Shin JH, Suh SP, Ryang DW, Shin MG. Constitutional chromosomal abnormality identified in a sibling donor after bone marrow stem cell transplantation in a pediatric patient with acute megakaryoblastic leukemia. Ann Lab Med 2015; 35:162-4. [PMID: 25553302 PMCID: PMC4272953 DOI: 10.3343/alm.2015.35.1.162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 08/20/2014] [Accepted: 11/21/2014] [Indexed: 11/19/2022] Open
Affiliation(s)
- Bo-Young Seo
- Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Hyun-Woo Choi
- Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Min-Gu Kang
- Environmental Health Center for Childhood Leukemia and Cancer, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Duck Cho
- Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Seung-Jung Kee
- Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Soo-Hyun Kim
- Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Jong-Hee Shin
- Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Soon-Pal Suh
- Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Dong-Wook Ryang
- Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Myung-Geun Shin
- Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea. ; Environmental Health Center for Childhood Leukemia and Cancer, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea. ; Brain Korea 21 Plus Project, Chonnam National University Medical School, Gwangju, Korea
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Salazar-Riojas R, García-Lozano JA, Valdés-Galván M, Martínez-González O, Cantú-Rodríguez OG, González-Llano O, Gómez-De León A, Jaime-Pérez JC, Gómez-Almaguer D, Gutiérrez-Aguirre CH. Effective collection of peripheral blood stem cells in children weighing 20 kilogram or less in a single large-volume apheresis procedure. J Clin Apher 2014; 30:281-7. [PMID: 25557252 DOI: 10.1002/jca.21375] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 11/30/2014] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Peripheral blood stem cell (PBSC) transplantation has become a routine procedure in pediatric oncology. A special group of PBSC donors are children weighing 20 kg or less. Limited vascular access and low blood volume puts them at a higher risk. Central line placement and a priming apheresis machine are recommended to avoid these complications. PATIENTS AND METHODS PBSC collections performed from July 2006 to May 2013 in children weighing less than 20 kg were included. All donors had a central venous catheter (CVC). An apheresis machine was primed with packet red blood cells. RESULTS Twenty-seven PBSC collections were performed in 22 children weighing 20 kg or less, 14 for allogeneic and 8 for autologous transplantation, in order to collect at least 2 × 10(6) CD34+ cells/kg. In the allogeneic group, median age and weight were 3 years (0.8-7) and 15.5 kg (8-20). In the autologous group, median age and weight were 3 years (2-7) and 15.35 kg (12.5-19.5). A single large-volume apheresis was sufficient to obtain the CD34+ cells needed in 78.5% and 75% of the allogeneic and autologous groups, respectively, with a median 11.84 × 10(6) and 5.79 × 10(6) CD34+ cells collected per kilogram of weight of the recipient. No serious complications related to the apheresis procedure or CVC placement occurred. CONCLUSION PBSC collection in a single large-volume apheresis for allogeneic and autologous transplants in children weighing 20 kg or less is a safe and effective procedure when based on standardized protocols.
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Affiliation(s)
- Rosario Salazar-Riojas
- Servicio De Hematología, Hospital Universitario "Dr. José Eleuterio González," U.A.N.L., Monterrey, Nuevo Leon, México
| | - José Alberto García-Lozano
- Servicio De Hematología, Hospital Universitario "Dr. José Eleuterio González," U.A.N.L., Monterrey, Nuevo Leon, México
| | - Mayra Valdés-Galván
- Servicio De Hematología, Hospital Universitario "Dr. José Eleuterio González," U.A.N.L., Monterrey, Nuevo Leon, México
| | - Odra Martínez-González
- Servicio De Hematología, Hospital Universitario "Dr. José Eleuterio González," U.A.N.L., Monterrey, Nuevo Leon, México
| | - Olga Graciela Cantú-Rodríguez
- Servicio De Hematología, Hospital Universitario "Dr. José Eleuterio González," U.A.N.L., Monterrey, Nuevo Leon, México
| | - Oscar González-Llano
- Servicio De Hematología, Hospital Universitario "Dr. José Eleuterio González," U.A.N.L., Monterrey, Nuevo Leon, México
| | - Andrés Gómez-De León
- Servicio De Hematología, Hospital Universitario "Dr. José Eleuterio González," U.A.N.L., Monterrey, Nuevo Leon, México
| | - José Carlos Jaime-Pérez
- Servicio De Hematología, Hospital Universitario "Dr. José Eleuterio González," U.A.N.L., Monterrey, Nuevo Leon, México
| | - David Gómez-Almaguer
- Servicio De Hematología, Hospital Universitario "Dr. José Eleuterio González," U.A.N.L., Monterrey, Nuevo Leon, México
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Suenaga F, Ueha S, Abe J, Kosugi-Kanaya M, Wang Y, Yokoyama A, Shono Y, Shand FHW, Morishita Y, Kunisawa J, Sato S, Kiyono H, Matsushima K. Loss of Lymph Node Fibroblastic Reticular Cells and High Endothelial Cells Is Associated with Humoral Immunodeficiency in Mouse Graft-versus-Host Disease. THE JOURNAL OF IMMUNOLOGY 2014; 194:398-406. [DOI: 10.4049/jimmunol.1401022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Abstract
Recent advances in the treatment of aplastic anemia (AA) made most of patients to expect to achieve a long-term survival. Allogeneic stem cell transplantation (SCT) from HLA-matched sibling donor (MSD-SCT) is a preferred first-line treatment option for younger patients with severe or very severe AA, whereas immunosuppressive treatment (IST) is an alternative option for others. Horse anti-thymocyte globuline (ATG) with cyclosporin A (CsA) had been a standard IST regimen with acceptable response rate. Recently, horse ATG had been not available and replaced with rabbit ATG in most countries. Subsequently, recent comparative studies showed that the outcomes of patients who received rabbit ATG/CsA were similar or inferior compared to those who received horse ATG/CsA. Therefore, further studies to improve the outcomes of IST, including additional eltrombopag, are necessary. On the other hand, the upper age limit of patients who are able to receive MSD-SCT as first-line treatment is a current issue because of favorable outcomes of MSD-SCT of older patients using fludarabine-based conditioning. In addition, further studies to improve the outcomes of patients who receive allogeneic SCT from alternative donors are needed. In this review, current issues and the newly emerging trends that may improve their outcomes in near futures will be discussed focusing the management of patients with AA.
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Affiliation(s)
- Seung Hwan Shin
- Department of Hematology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Eun Lee
- Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong Wook Lee
- Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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44
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Estcourt LJ. Why has demand for platelet components increased? A review. Transfus Med 2014; 24:260-8. [DOI: 10.1111/tme.12155] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 06/24/2014] [Accepted: 09/06/2014] [Indexed: 01/16/2023]
Affiliation(s)
- L. J. Estcourt
- NHS Blood and Transplant; Oxford UK
- Radcliffe Department of Medicine; University of Oxford; Oxford UK
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45
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A novel approach for the enumeration of peripheral blood stem cells suitable for transplantation. J Transplant 2014; 2014:473503. [PMID: 25165572 PMCID: PMC4138781 DOI: 10.1155/2014/473503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 07/23/2014] [Indexed: 01/01/2023] Open
Abstract
Stem cells have the capability to proliferate and differentiate into various cells of the body. Few stem cell sources have been approved for transplantation, among them are the hematopoietic progenitor cells which are progenitors of the myeloid and erythroid lineage in the hematopoietic system, that continually provides mature blood cells during the lifespan of the individual. These well-characterized stem cells are clinically relevant in the treatment of diseases such as breast cancer, leukemias, and congenital immunodeficiencies. Peripheral blood stem transplantation is a standard procedure after its first successful transplantation more than 35 years ago. The minimum intended dose of stem cells given to the patient is 2.5 × 10(6) -5 × 10(6) cells. In this study, we are establishing a correlation between the number of stem cells enumerated and the weight of the patient as a determinant for suitable transplantation. We have established a conversion factor to deliver the required dose of approximately 3 × 10(6) stem cells/kg body weight. This will ensure a uniform collection strategy that is sufficient for transplantation irrespective of the weight of the patient. This approach, if incorporated, will lead to a significantly lesser rate of bone marrow transplantation failures as sufficient number of stem cells will ensure engraftment of stem cells.
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Morris C, de Wreede L, Scholten M, Brand R, van Biezen A, Sureda A, Dickmeiss E, Trneny M, Apperley J, Chiusolo P, van Imhoff GW, Lenhoff S, Martinelli G, Hentrich M, Pabst T, Onida F, Quinn M, Kroger N, de Witte T, Ruutu T. Should the standard dimethyl sulfoxide concentration be reduced? Results of a European Group for Blood and Marrow Transplantation prospective noninterventional study on usage and side effects of dimethyl sulfoxide. Transfusion 2014; 54:2514-22. [DOI: 10.1111/trf.12759] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 02/18/2014] [Accepted: 02/20/2014] [Indexed: 12/30/2022]
Affiliation(s)
- Curly Morris
- Centre for Cancer Research and Cell Biology; Queen's University of Belfast; Belfast UK
| | - Liesbeth de Wreede
- EBMT, Department of Medical Statistics and Bioinformatics; Leiden University Medical Center; Leiden The Netherlands
| | - Marijke Scholten
- EBMT, Department of Medical Statistics and Bioinformatics; Leiden University Medical Center; Leiden The Netherlands
| | - Ronald Brand
- EBMT, Department of Medical Statistics and Bioinformatics; Leiden University Medical Center; Leiden The Netherlands
| | - Anja van Biezen
- EBMT, Department of Medical Statistics and Bioinformatics; Leiden University Medical Center; Leiden The Netherlands
| | - Anna Sureda
- Department of Haematology, Addenbrooke's Hospital; Cambridge University; Cambridge UK
| | - Ebbe Dickmeiss
- Cell Therapy Section, Department of Clinical Immunology; Rigshospitalet; Copenhagen Denmark
| | - Marek Trneny
- Charles University Hospital; Prague Czech Republic
| | - Jane Apperley
- Department of Haematology; Hammersmith Hospital; London UK
| | | | - Gustaaf W. van Imhoff
- Department of Hematology; University Medical Center Groningen; Groningen The Netherlands
| | - Stig Lenhoff
- Department of Hematology; University Hospital; Lund Sweden
| | | | | | | | - Francesco Onida
- Department of Hematology and Oncology; University of Milan; Milan Italy
| | - Michael Quinn
- Department of Haematology; Belfast City Hospital; Belfast UK
| | - Nicolaus Kroger
- Department of Stem Cell Transplantation; University Hospital Hamburg-Eppendorf; Hamburg Germany
| | - Theo de Witte
- Department of Hematology; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - Tapani Ruutu
- Department of Medicine; Helsinki University Central Hospital; Helsinki Finland
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Holtick U, Albrecht M, Chemnitz JM, Theurich S, Skoetz N, Scheid C, von Bergwelt‐Baildon M. Bone marrow versus peripheral blood allogeneic haematopoietic stem cell transplantation for haematological malignancies in adults. Cochrane Database Syst Rev 2014; 2014:CD010189. [PMID: 24748537 PMCID: PMC10612998 DOI: 10.1002/14651858.cd010189.pub2] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is an established treatment option for many malignant and non-malignant disorders. In the past two decades, peripheral blood stem cells replaced bone marrow as stem cell source due to faster engraftment and practicability. Previous meta-analyses analysed patients treated from 1990 to 2002 and demonstrated no impact of the stem cell source on overall survival, but a greater risk for graft-versus-host disease (GvHD) in peripheral blood transplants. As transplant indications and conditioning regimens continue to change, whether the choice of the stem cell source has an impact on transplant outcomes remains to be determined. OBJECTIVES To assess the effect of bone marrow versus peripheral blood stem cell transplantation in adult patients with haematological malignancies with regard to overall survival, incidence of relapse and non-relapse mortality, disease-free survival, transplant-related mortality, incidence of GvHD and time to engraftment. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 1), MEDLINE (from 1948 to February 2014), trial registries and conference proceedings. The search was conducted in October 2011 and was last updated in February 2014. We did not apply any language restrictions. SELECTION CRITERIA We included randomised controlled trials (RCTs) comparing bone marrow and peripheral blood allogeneic stem cell transplantation in adults with haematological malignancies. DATA COLLECTION AND ANALYSIS Two review authors screened abstracts and extracted and analysed data independently. We contacted study authors for additional information. We used the standard methodological procedures expected by The Cochrane Collaboration. MAIN RESULTS We included nine RCTs that met the pre-defined selection criteria, involving a total of 1521 participants. Quality of data reporting was heterogeneous among the studies. Overall, the risk of bias in the included studies was low.For the primary outcome overall survival, our analysis demonstrated comparable results between bone marrow transplantation (BMT) and peripheral blood stem cell transplantation (PBSCT) (six studies, 1330 participants; hazard ratio (HR) 1.07; 95% CI 0.91 to 1.25; P value = 0.43; high-quality evidence).Disease-free survival (six studies, 1225 participants; HR 1.04; 95% CI 0.89 to 1.21; P value = 0.6; moderate-quality of evidence) and non-relapse or transplant-related mortality (three studies, 758 participants; HR 0.98; 95% CI 0.76 to 1.28; P = 0.91; high-quality evidence) were also comparable between transplantation arms.In the related-donor setting, data from two of eight studies with 211 participants (21%) indicated a higher relapse incidence in participants transplanted with bone marrow stem cells rather than peripheral blood stem cells (HR 2.73; 95% CI 1.47 to 5.08; P value = 0.001). There was no clear evidence of a difference in relapse incidence between transplantation groups in unrelated donors (HR 1.07; 95% CI 0.78 to 1.47; P value = 0.66). The difference between the donor-related and -unrelated subgroups (P-value = 0.008) was considered to be statistically significant.BMT was associated with lower rates of overall and extensive chronic GvHD than PBSCT (overall chronic GvHD: four studies, 1121 participants; HR 0.72; 95% CI 0.61 to 0.85; P value = 0.0001, extensive chronic GvHD: four studies, 765 participants; HR 0.69; 95% CI 0.54 to 0.9; P value = 0.006; moderate-quality evidence for both outcomes). The incidence of acute GvHD grades II to IV was not lower (six studies, 1330 participants; HR 1.03; 95% CI 0.89 to 1.21; P value = 0.67; moderate-quality evidence), but there was a trend for a lower incidence of grades III and IV acute GvHD with BMT than with PBSCT (three studies, 925 participants; HR 0.75; 95% CI 0.55 to 1.02; P value = 0.07; moderate-quality evidence).Times to neutrophil and platelet engraftment were longer with BMT than with PBSCT (neutrophil: five studies, 662 participants; HR 1.96; 95% CI 1.64 to 2.35; P value < 0.00001; platelet: four studies, 333 participants; HR 2.17; 95% CI 1.69 to 2.78; P value < 0.00001). AUTHORS' CONCLUSIONS This systematic review found high-quality evidence that overall survival following allo-HSCT using the current clinical standard stem cell source - peripheral blood stem cells - was similar to that following allo-HSCT using bone marrow stem cells in adults with haematological malignancies. We found moderate-quality evidence that PBSCT was associated with faster engraftment of neutrophils and platelets, but a higher risk of GvHD (in terms of more overall and extensive chronic GvHD). There was an imprecise effect on relapse and on severe (grades III to IV) acute GvHD. Quality of life, which is severely affected by GvHD, was not evaluated.Against the background of transplantation practices that have clearly changed over the past 10 to 15 years, our aim was to provide current data on the best stem cell source for allo-HSCT, by including the results of recently conducted trials. Our review includes participants recruited up to 2009, a proportion of whom were older, had received reduced-intensity conditioning regimens or had been transplanted with stem cells from unrelated donors. However, only one, large, study included relatively recently treated participants. Nevertheless, our findings are comparable to those of previous meta-analyses suggesting that our results hold true for today's practice.
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Affiliation(s)
- Udo Holtick
- University Hospital of CologneDepartment I of Internal Medicine, Stem Cell Transplantation ProgramCologneGermany50924
| | - Melanie Albrecht
- University Hospital of CologneDepartment I of Internal Medicine, Stem Cell Transplantation ProgramCologneGermany50924
| | - Jens M Chemnitz
- University Hospital of CologneDepartment I of Internal Medicine, Stem Cell Transplantation ProgramCologneGermany50924
| | - Sebastian Theurich
- University Hospital of CologneDepartment I of Internal Medicine, Stem Cell Transplantation ProgramCologneGermany50924
| | - Nicole Skoetz
- University Hospital of CologneCochrane Haematological Malignancies Group, Department I of Internal MedicineKerpener Str. 62CologneGermany50924
| | - Christof Scheid
- University Hospital of CologneDepartment I of Internal Medicine, Stem Cell Transplantation ProgramCologneGermany50924
| | - Michael von Bergwelt‐Baildon
- University Hospital of CologneDepartment I of Internal Medicine, Stem Cell Transplantation ProgramCologneGermany50924
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Raj K, Pagliuca A, Bradstock K, Noriega V, Potter V, Streetly M, McLornan D, Kazmi M, Marsh J, Kwan J, Huang G, Getzendaner L, Lee S, Guthrie KA, Mufti GJ, O'Donnell P. Peripheral blood hematopoietic stem cells for transplantation of hematological diseases from related, haploidentical donors after reduced-intensity conditioning. Biol Blood Marrow Transplant 2014; 20:890-5. [PMID: 24650678 DOI: 10.1016/j.bbmt.2014.03.003] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 03/01/2014] [Indexed: 12/20/2022]
Abstract
In a multicenter collaboration, we carried out T cell-replete, peripheral blood stem cell (PBSC) transplantations from related, HLA-haploidentical donors with reduced-intensity conditioning (RIC) and post-transplantation cyclophosphamide (Cy) as graft-versus-host disease (GVHD) prophylaxis in 55 patients with high-risk hematologic disorders. Patients received 2 doses of Cy 50 mg/kg i.v. on days 3 and 4 after infusion of PBSC (mean, 6.4 × 10(6)/kg CD34(+) cells; mean, 2.0 × 10(8)/kg CD3(+) cells). The median times to neutrophil (500/μL) and platelet (>20,000/μL) recovery were 17 and 21 days respectively. All but 2 of the patients achieved full engraftment. The 1-year cumulative incidences of grade II and grade III acute GVHD were 53% and 8%, respectively. There were no cases of grade IV GVHD. The 2-year cumulative incidence of chronic GHVD was 18%. With a median follow-up of 509 days, overall survival and event-free survival at 2 years were 48% and 51%, respectively. The 2-year cumulative incidences of nonrelapse mortality and relapse were 23% and 28%, respectively. Our results suggest that PBSC can be substituted safely and effectively for bone marrow as the graft source for haploidentical transplantation after RIC.
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Affiliation(s)
- Kavita Raj
- Guy's and St Thomas' NHS Hospitals Foundation Trusts, London, United Kingdom; Department of Haematological Medicine, King's College Hospital, London, United Kingdom
| | - Antonio Pagliuca
- Guy's and St Thomas' NHS Hospitals Foundation Trusts, London, United Kingdom; Department of Haematological Medicine, King's College Hospital, London, United Kingdom; King's College London, United Kingdom
| | | | - Victor Noriega
- Department of Haematological Medicine, King's College Hospital, London, United Kingdom
| | - Victoria Potter
- Department of Haematological Medicine, King's College Hospital, London, United Kingdom
| | - Matthew Streetly
- Guy's and St Thomas' NHS Hospitals Foundation Trusts, London, United Kingdom; Department of Haematological Medicine, King's College Hospital, London, United Kingdom
| | - Donal McLornan
- Guy's and St Thomas' NHS Hospitals Foundation Trusts, London, United Kingdom; Department of Haematological Medicine, King's College Hospital, London, United Kingdom
| | - Majid Kazmi
- Guy's and St Thomas' NHS Hospitals Foundation Trusts, London, United Kingdom; Department of Haematological Medicine, King's College Hospital, London, United Kingdom
| | - Judith Marsh
- Department of Haematological Medicine, King's College Hospital, London, United Kingdom; King's College London, United Kingdom
| | - John Kwan
- Westmead Hospital, Sydney, NSW, Australia
| | | | | | - Stephanie Lee
- Fred Hutchinson Cancer Research Center, Seattle, Washington; University of Washington, Seattle
| | | | - Ghulam J Mufti
- Department of Haematological Medicine, King's College Hospital, London, United Kingdom; King's College London, United Kingdom
| | - Paul O'Donnell
- Fred Hutchinson Cancer Research Center, Seattle, Washington; University of Washington, Seattle.
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Bertani G, Santoleri L, Martino M, Fedele R, Moscato T, Marenco P, Grillo G, Zucchetti E, Lotesoriere I, Lando G, Cesana C, Cairoli R, Rossini S. Identification of hematopoietic progenitor cell donor characteristics predicting successful mobilization: results of an Italian multicenter study. Transfusion 2014; 54:2028-33. [DOI: 10.1111/trf.12612] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 12/23/2013] [Accepted: 12/27/2013] [Indexed: 12/11/2022]
Affiliation(s)
| | - Luca Santoleri
- Transfusion Medicine Department; Ospedale Niguarda Ca' Granda; Milan Italy
| | - Massimo Martino
- Hematology Department; Ospedale Bianchi Melacrino Morelli; Reggio Calabria Italy
| | - Roberta Fedele
- Hematology Department; Ospedale Bianchi Melacrino Morelli; Reggio Calabria Italy
| | - Tiziana Moscato
- Hematology Department; Ospedale Bianchi Melacrino Morelli; Reggio Calabria Italy
| | - Paola Marenco
- Hematology Department; Ospedale Niguarda Ca' Granda; Milan Italy
| | - Giovanni Grillo
- Hematology Department; Ospedale Niguarda Ca' Granda; Milan Italy
| | - Elisa Zucchetti
- Hematology Department; Ospedale Niguarda Ca' Granda; Milan Italy
| | | | - Giuliana Lando
- Transfusion Medicine Department; Ospedale Niguarda Ca' Granda; Milan Italy
| | - Clara Cesana
- Transfusion Medicine Department; Ospedale Niguarda Ca' Granda; Milan Italy
| | - Roberto Cairoli
- Oncology and Hematology Department; Ospedale Valduce; Como Italy
| | - Silvano Rossini
- Transfusion Medicine Department; Ospedale Niguarda Ca' Granda; Milan Italy
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50
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A review of the haematopoietic stem cell donation experience: is there room for improvement? Bone Marrow Transplant 2014; 49:729-36. [DOI: 10.1038/bmt.2013.227] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 11/29/2013] [Accepted: 12/02/2013] [Indexed: 11/08/2022]
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